Concomitant cardiac and pulmonary operation: The role of cardiopulmonary bypass

Ulicny, Karl S.; Schmelzer, Victor; Flege, John B.; Todd, Joseph C.; Mitts, Donald L.; Melvin, David; Wright, Creighton B.

doi:10.1016/0003-4975(92)91387-o

Cited by 49 publications

(45 citation statements)

References 21 publications

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“…CABG with CPB has been widely shown to be an effective procedure in patients with severe ischemic heart disease for several decades, but CPB may activate systemic inflammatory response syndrome, impair the immune response, deplete complement system factors, and cause lymphopenia, neutropenia, pulmonary sequestration of polymorphonuclear cells, and/or suppression of natural killer cells (14,15).…”

Section: Discussionmentioning

confidence: 99%

Lung cancer resection with concurrent off-pump coronary artery bypasses: safety and efficiency

Ma¹,

Huang²,

Zhang³

et al. 2016

J. Thorac. Dis.

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Background: To assess the safety and efficacy of combined surgery for patients with concurrent lung cancer and severe coronary heart disease (CHD). Methods: Between 2003 and 2014, 34 patients with stage I or II lung cancer and simultaneous severe CHD underwent combined off-pump coronary artery bypass (OPCAB) grafting and lung resection. Surgically, myocardial revascularization was performed first and followed by lobectomies through the same or a second incision. Video-assisted thoracoscopes were used in some cases. Five patients also received chemotherapy before or after combined surgery in an effort to improve the long-term survival. Results: All patients survived the operation and no new myocardial infarctions (MIs) occurred in the perioperative period. The most frequent complications were cardiac arrhythmias (5 cases), atelectasis (4 cases), and pulmonary infections (2 cases). All patients were followed up for 5-60 months. Within this period, 6 patients (17.6%) died due to cancer recurrence. The 3-and 5-year survivals were 75% and 67% for these lung cancer patients, respectively. Conclusions: Combined OPCAB and pulmonary resection for early stage lung cancer patients with concurrent severe CHD is a relatively safe and effective treatment with satisfactory long-term survival rates, especially for those patients with three-vessel disease who are not usually candidates for percutaneous coronary intervention (PCI) before open surgery.

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Section: Discussionmentioning

confidence: 99%

Lung cancer resection with concurrent off-pump coronary artery bypasses: safety and efficiency

Ma¹,

Huang²,

Zhang³

et al. 2016

J. Thorac. Dis.

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“…In contrast, Ulicny et al advocated that pulmonary resection performed with CPB leads to excessive bleeding and pulmonary complications. 6) In this case, we concluded that concomitant lobectomy with on-pump CABG would not be needed, and preoperative TAE was thought to be enough to prevent perioperative severe hemoptysis. In summary, we treated a 75-year-old man with bronchiectasis and unstable angina pectoris who underwent TAE for a systemicpulmonary shunt preceding CABG with CPB.…”

Section: Discussionmentioning

confidence: 76%

Coronary Artery Bypass Grafting in a Patient with Unstable Angina Pectoris and Bronchiectasis

Oda¹,

Yasunaga²,

Matsumura

et al. 2014

ATCS

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Bronchiectasis is characterized by the abnormal and permanent dilatation of bronchi. Clinical manifestations of bronchiectasis include persistent or recurrent cough, purulent sputum, hemosputum, and hemoptysis. A 75-year-old man with bronchiectasis required coronary bypass grafting for unstable angina pectoris with severe stenosis of the left main trunk. Computed tomography showed fistulae between the dilated bronchial arteries and the left pulmonary artery. Cardiac catheter examination showed significant left-right shunt and left ventricular dilatation. To avoid perioperative massive hemoptysis, embolizations of 2 bronchial arteries and an inferior phrenic artery were performed preceding the coronary artery bypass grafting. Both transcatheter embolization and coronary artery bypass grafting were successfully performed without any complications. Herein, we illustrate a very rare case of bronchiectasis in a patient with unstable angina pectoris who underwent transcatheter embolization for a systemic-pulmonary shunt preceding coronary artery bypass grafting with cardiopulmonary bypass.

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“…1 Some authors have reported on patients undergoing cardiopulmonary bypass whose immunological responses to their malignancies may have been adversely affected. 7 However, there has been no convincing evidence that cardiopulmonary bypass infl uences the prognosis of malignancies. 8 The poor outcome of most cases that required combined pulmonary and cardiac operations might have been infl uenced by the patients' serious cardiac condition, such as coronary or valvular disease.…”

Section: Discussionmentioning

confidence: 99%

“…7 The reasons that resection of a cardiac tumor should precede resection of a lung carcinoma include the need to diagnose the cardiac tumor defi nitively, which is essential to the patient's therapeutic plan, and the urgent need to remove cardiac tumors as soon as possible because they are often subject to embolization and sometimes result in sudden death. 1 Some authors have reported on patients undergoing cardiopulmonary bypass whose immunological responses to their malignancies may have been adversely affected.…”

Section: Discussionmentioning

confidence: 99%

Concomitant surgery of a left atrial myxoma and a pulmonary carcinoma

Nakanishi

Nagaie

Tanaka

et al. 2007

Gen Thorac Cardiovasc Surg

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We report the first successful outcome of a patient undergoing concomitant surgery for a left atrial myxoma and a squamous cell carcinoma of the lung. Preoperative evaluations revealed lung cancer and a left atrial tumor of undetermined origin. An operation to excise both cardiac and pulmonary tumors was performed. The cardiac tumor was first resected with the aid of cardiopulmonary bypass. The histopathological diagnosis was myxoma. Resection of the left upper pulmonary lobe and mediastinal lymph nodes followed. The postoperative course was uneventful, and the patient is well without evidence of recurrence 7 years after the operation.

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Concomitant cardiac and pulmonary operation: The role of cardiopulmonary bypass

Cited by 49 publications

References 21 publications

Lung cancer resection with concurrent off-pump coronary artery bypasses: safety and efficiency

Lung cancer resection with concurrent off-pump coronary artery bypasses: safety and efficiency

Coronary Artery Bypass Grafting in a Patient with Unstable Angina Pectoris and Bronchiectasis

Concomitant surgery of a left atrial myxoma and a pulmonary carcinoma

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